In-Home End-of-Life
Nursing Care & Support
In-Home
End-of-Life
Nursing Care
& Support
Compassionate Medical Support for Families Throughout Vermont
When someone you love is nearing the end of life, the responsibility of care can feel overwhelming, especially when you are trying to manage complex medical needs while being present as family.
At River’s Reflections, I provide calm, experienced, hands-on nursing care
in the home so you do not have to carry this alone.
Services
My role is not only to support physical needs, but to help create an environment where this time can be met with dignity, calm, and respect for each individual's wishes.
My role is not only to support physical needs, but to help create an environment where this time can be met with
dignity, calm, and respect for each individual's wishes.
In-Home End-of-Life Nursing Care
I provide skilled nursing care focused on comfort, dignity, and quality of life in your loved one’s home. This includes assistance with personal care, repositioning, and ongoing attention to comfort and dignity.
During the final stages, I can also be present for extended periods or overnight — ensuring your loved one is never alone, and that you have space to rest. I'm available to work in private homes, assisted living communities, and independent living facilities throughout Vermont.
Symptom & Medication Management
Managing symptoms and medications at the end of life can feel overwhelming and uncertain. I provide ongoing assessment and support to ensure medications are given safely, changes are recognized early, and care stays aligned with your loved one's wishes.
As a Registered Nurse, I am clinically trained to administer medications, monitor their effects, and adjust care in real time. This is one of the most meaningful ways I can take the medical weight off your shoulders — and off your conscience.
I also serve as an advocate, helping ensure your loved one's needs and preferences are honored while keeping you informed and supported as things evolve.
Bridging the
Hospice Gap
Hospice is a vital part of end-of-life care. However, the reality is that most hospice teams can only visit for a few hours each week. That leaves families managing complex medical needs, emotional uncertainty, and the fear of doing something wrong — largely on their own.
I work alongside your hospice team to bridge the gap between scheduled visits and the day-to-day reality of life at home.
Think of me as the consistent clinical presence that helps transform an overwhelming situation into one that feels supported, informed, and more manageable.
You are not only caring for your loved one. You are grieving too.
Alongside medical care, I provide emotional support, guidance, reassurance, and honest communication so families feel less alone and more grounded during this time.
My approach is shaped not only by clinical experience, but by my own personal journey with grief and caregiving.
When welcomed, I may also incorporate Reiki — a gentle, non-invasive practice that can help promote calm, relaxation, and emotional well-being for both patients and loved ones.
Reiki is always optional and never expected.
Emotional Support
Some of the most sacred hours of a person's life happen at the end of it. I offer a steady, compassionate presence at the bedside — attentive to comfort, attuned to subtle shifts, and available to guide your family through whatever unfolds.
I hold the medical watch so you can hold your loved one's hand.
Bedside Vigil
Flexible, Personal Care
Care is always tailored to your loved one's needs and can shift as things change. Support may look like a few hours during the day, overnight care, or more continuous presence. Some families need consistent daily support; others need help during specific moments.
We'll talk through what feels right for your situation and adjust as needed.
When Families Reach Out
Many families contact me because:
Hospice visits do not feel like enough support
They are overwhelmed managing medications and symptoms
They are afraid of doing something wrong
Their loved one needs more hands-on care at home
They want their loved one to remain comfortable and dignified
They need support balancing caregiving with simply being family
They feel emotionally unprepared for what lies ahead
If your loved one is actively transitioning and you need support now, please reach out immediately, and I will do everything I can to be there.
“We're so lucky to have had you on this journey with us. Thank you so much for everything.”
- K.K.
How It Works
Reach Out
Contact me and share what is happening and where you need support.
Initial Conversation
We will connect by phone or video to talk through your loved one’s needs, wishes, and care goals.
Care Begins
I can often step in quickly and begin providing support based on your family’s immediate needs.
Ongoing Support
Care remains flexible and adapts as things change. I am with you for as long as you need.
Meet Heather
I'm Heather, a Registered Nurse licensed in Vermont and New York with 16 years of clinical experience, including seven years specializing in oncology and hematology. I hold a Bachelor of Arts in Sociology and Psychology, am a certified massage therapist, and have achieved Reiki mastery.
My approach to end-of-life care blends rigorous medical training with deep emotional attunement, because the families I work with need both. I have also walked my own grief journey, which shapes everything about how I show up at the bedside.
Frequently Asked Questions
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Hospice provides an essential foundation of care, but most hospice teams are only able to visit for limited periods each week.
I provide the additional in-home support families often need between hospice visits — including hands-on nursing care, symptom management, bedside presence, and emotional support.
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Yes. As a Registered Nurse, I am trained and qualified to safely administer medications, monitor their effects, and respond appropriately to changes in condition.
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River’s Reflections is a private-pay service. Care is billed hourly and structured around your family’s needs. Many families find support more affordable than they expected, and I am happy to discuss options during our first conversation.
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Care is provided at an hourly rate of $75/hour. Every family’s needs are different, so support can be as minimal or as involved as feels right for your situation.
River’s Reflections is a private-pay service. During our first conversation, we can talk through what kind of support would feel most helpful and what that may look like financially.
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Many families reach out needing immediate support, and I do my best to respond quickly. If your loved one is actively transitioning, please contact me right away.
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I serve families throughout Vermont and may be available to travel into neighboring states when needed.
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Yes. I work with individuals living with terminal or serious illnesses including cancer, ALS, COPD, Parkinson’s disease, dementia, and heart failure, whether or not formal hospice services have begun.
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Yes. I provide compassionate, nonjudgmental support to individuals and families navigating end-of-life decisions, including those considering or pursuing Medical Aid in Dying where legally available.
My role is to offer steady emotional support, comfort-focused care, advocacy, and bedside presence while honoring each person’s values, wishes, and autonomy.
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No. Reiki is always optional and only offered when it feels appropriate and welcome.
I believe our final transition deserves presence, care, and sacred witness.
You don’t have to walk this alone. I’m here when you’re ready.